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Thursday, June 29, 2017

Type 2 Diabetes, a Dietary Disease #387: 15 Years on a VLC Diet

In August 2002 my doctor asked me
to go to a website I’d never heard of, study a diet plan described there, and
then start the diet when he returned from vacation two weeks later. He wanted
to monitor me closely.

The impetus for his interest in
this website was the cover story of the July 7, 2002, New York Times Sunday Magazine that he had read a month before, “What If It's All Been a Big Fat Lie?” by
Gary Taubes. The cover photo was of a ribeye steak with a big pat of butter on
top. He had tried the diet himself…and it worked.

The website was Atkins and the diet
was the startup phase called “Atkins Induction” in which the dieter goes “cold
turkey” from eating the Standard American or Western Diet to consuming just 20
grams of carbs a day. That’s very low. Today anything below 50g/d is
described as Very Low Carb and up to 100 as Low Carb.

Very Low Carb (VLC) is similar to
the Very Low Carb Ketogenic Diet (VLCKD) and also to the Low-Carb, High-Fat
(LCHF) diet. LCHF stresses quality saturated and monounsaturated fats. All eschew vegetable and seed oils.

Followers will differ in their
precise definitions, but most agree that they are all characterized by being LOW
carb, MODERATE protein and HIGH fat. The high fat part is still the most
controversial and easily the hardest for neophytes to accept. Despite being a
hard sell, high fat is an important part of the plan.

We have been told for more than
half a century that consuming fat, especially saturated fat with cholesterol,
is a risk factor for heart disease. That guidance was not supported by good
science and today is increasingly coming under review and criticism by a
growing number of reputable sources. But the AHA, the Standards of Practice of
the medical specialties, the government Dictocrats who influence payments by
Medicare/Medicaid and private health insurers, and most practicing physicians are still wary and way, way behind the curve, as is the mass
media. So, in this context patients generally do what their doctor tells them
to do. I did.

And who can blame them? I just got
lucky. My doctor had been trying to get me to lose weight for years. I saw his
staff nutritionist and tried to follow the low-fat (high-carb!), “BALANCED” diet she prescribed for me. It didn’t work.
Whenever I lost weight, my metabolism slowed, I was hungry, and I re-gained.
And I felt like crap. My body told me to eat
for energy balance. It didn’t like to
starve. I didn’t like it either. So I failed, repeatedly.

What was different about this diet (Very Low Carb: 20 grams a day)?
I wasn’t hungry. I didn’t
crave food. My body was in energy balance and didn’t slow down because, when it needed energy,
it switched from the food I ate to the food it
had stored. It could do this because
the food I ate was VERY LOW CARB.
This meant that after the level of glucose (from carbs) in my blood dropped,
the level of INSULIN in my
blood also dropped. The insulin
wasn’t needed to transport glucose to my cells. So, seeing lower blood insulin, the brain got the signal
to switch from using glucose for energy to
burning body fat for energy.

Everybody’s level-of-carb threshold
is going to be different. Among other things, it depends on the level of
Insulin Resistance (IR) you have developed over a lifetime of eating 60%
carbohydrates the way we have been told to do since 1977. That’s 300 grams of carbohydrates a day on a
2,000 kcal diet and 375 grams on a
2,500 kcal diet (for men). So, everyone
who eats just 20 grams of carbohydrates a
daywill lose weight easily and
without hunger. In the first 9 months I lost 60 pounds, and kept it off. It was life
changing. Life saving, I think.

This is not an endorsement
of Atkins, especially since it has changed so much since I did it 15 years ago.
I later moved on to Bernstein (30g carbs/day) and lost 110 more. Today I am
still 170 lbs. lighter than I was in 2002.

About Me

I was diagnosed a Type 2 diabetic in 1986. I started a Very Low Carb diet (Atkins Induction) in 2002 to lose weight. I didn’t realize at the time that it would put my diabetes in clinical remission, or that I would be able to give up almost all of my oral diabetes meds. I also didn’t understand that, as I lost weight and continued to eat Very Low Carb, my blood lipids would dramatically improve (doubling my HDL and cutting my triglycerides by 2/3rds) and that my blood pressure would drop from 130/90 to 110/70 on the same meds.
Over the years I changed from Atkins to the Bernstein Diet (designed for diabetics) and, altogether lost 170 pounds. I later regained some and then lost some. As long as I eat Very Low Carb, I am not hungry and I have lots of energy. And I no longer have any of the indications of Metabolic Syndrome.
My goal, as long as I have excess body fat, is to remain continuously in a ketogenic state, both for blood glucose regulation and continued weight loss. I expect that this regimen will continue to provide the benefits of reduced systemic inflammation, improved blood lipids and lower blood pressure as well.